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This critical analysis of the role of transnational women's groups in setting the international and national agendas for women's health reviews a decade of women's participation in UN conferences, transnational networks, national advocacy efforts and sexual and reproductive health provision. It presents case studies of national-level reform and advocacy efforts and appraises the controversy concerning TRIPS, trade, and essential AIDS drugs. Petchesky reviews the formidable political and ideological forces confronting global justice movements and offers a sobering reassessment of transnational women's NGOs. She argues that the power of women's transnational coalitions is only as great as their organic connection with grassroots social movements.